Individual
AMANDA MARIA REAL DE LA PAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1521 FOREST HILL BLVD STE 3B, LAKE CLARKE SHORES, FL 33406-6031
(561) 506-3665
(561) 444-2458
Mailing address
5246 CANNON WAY, WEST PALM BEACH, FL 33415-4005
(305) 560-4205
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-136009
FL
Other
Enumeration date
04/21/2021
Last updated
03/28/2022
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